Wong Pak Chiu, Chan Yiu Che, Law Yuk, Keung Cheng Stephen Wing
Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
Asian Cardiovasc Thorac Ann. 2017 Nov;25(9):649-652. doi: 10.1177/0218492317741788. Epub 2017 Nov 2.
Two patients with locally advanced squamous cell carcinoma of the mid-esophagus, with esophageal stents in situ, suffered sudden onset of massive hematemesis and hemodynamic instability due to an aortoesophageal fistula. Although their esophageal neoplasms were deemed inoperable and treatment was palliative, the bleeding was successfully stopped with an endovascular aortic stent-graft. They both remained stable with no septic or hemorrhagic complications, and survived for 14 and 16 weeks after the operation. We emphasize that even if esophageal tumors are locally advanced, emergency endovascular management of aortoesophageal fistula is worthwhile for prolongation of survival.
两名患有中段食管局部晚期鳞状细胞癌且已植入食管支架的患者，因主动脉食管瘘突然发生大量呕血和血流动力学不稳定。尽管他们的食管肿瘤被认为无法手术切除且治疗为姑息性，但通过血管内主动脉覆膜支架成功止住了出血。他们术后均保持稳定，无感染或出血并发症，分别存活了14周和16周。我们强调，即使食管肿瘤为局部晚期，对主动脉食管瘘进行紧急血管内治疗对于延长生存期也是值得的。
